Clinical Observation Of Local Polidocanol Sclerotherapy In The Treatment Of Grade Ⅲ Internal Hemorrhoids

Objective 60 patients with grade Ⅲ internal hemorrhoids were treated with sclerotheapy and PPH respectively,and the preoperative condition,postoperative curative effect,complications and cost were observed to explore the best treatment of grade Ⅲ internal hemorrhoids.Methods Sixty patients with grade Ⅲ internal hemorrhoids were semi-randomly divided into experimental group(30 cases treated with polidocanol sclerotheapy)and control group(30 cases treated with PPH operation).The postoperative complications such as infection,induration,rectum stricture and uroschesis were recorded.Results 1.curative effect:In the experimental group,14 cases were cured(46.7%),7 cases were more effective(23.3%),6 cases were effective(20%).In control group,17 cases were cured(56.7%),6 cases were more effective(20%),4 cases were effective(13.3%).There was no significant difference in cure rate between the two groups(P > 0.05).2.Postoperative complications: 1)hematochezia: there was 1 case of hematochezia recurrence in experimental group(3.3%)and 3 cases of hematochezia recurrence in control group(10%).There was no significant difference in the incidence of hematochezia between the two groups(P > 0.05).2)tumor prolapse recurrence: there was 2 cases(6.7%)in experimental group and 0 cases(0%)in control group.There was no significant difference in the incidence of tumor prolapse recurrence between the two groups(P > 0.05).3)pain(3 days after operation): in experimental group,postoperative pain was25 cases(83.3%)in degree Ⅰ,4 cases(13.3%)in degree Ⅱ,1 case(3.3%)in degree Ⅲ,0 case(0%)in degree Ⅳ;In the control group,postoperative pain was 8 cases(26.7%)in degree Ⅰ,16 cases(53.4%)in degree Ⅱ,6 cases(20%)indegree Ⅲ,0 cases(0%)in degree Ⅳ.And there was significant difference in the degree of pain between the two groups(P < 0.05).4)infection: there were 0 cases(0%)in experimental group and 2 cases(6.7%)in operation group.There was no significant difference in the incidence of infection between the two groups(P > 0.05).5)induration: there were 4 cases(13.3%)in the experimental group and 0 cases(0%)in the control group,and there was no significant difference between the two groups(P > 0.05).6)rectal stenosis: experimental group was 0 cases(0%).operation group was 1 case(3.3%).there was no significant difference between the two groups(P > 0.05).7)urinary retention: there were 0 cases(0%)in experimental group and 1 case(3.3%)in control group.There was no significant difference in the incidence of urinary retention between the two groups(P > 0.05).8)perianal edema: there were 0 cases(0%)in the experimental group and 5 cases(16.7%)in the control group,and there was significant difference in the incidence of perianal edema between the two groups(P < 0.05).Conclusion 1.There was no significant difference between the curative effect of anoscope polidocanol sclerotheapy and PPH operation in the treatment of grade 3 internal hemorrhoids.2.The complications of anal endoscopic polidocanol sclerotheapy were less than the PPH operation.Patients do not have to suffertoo much.And the cost was less and the treatment time was shorter.There are better economic and social benefits.3.Compared with PPH operation,polidocanol sclerotheapy under anoscope is simpler in clinical operation and more reliable in curative effect,so it is suitable for popularization to grass-roots hospitals.